<div>
  <select id="imageSource">
    <option value="media">Media library</option>
    <option value="external">External</option>
  </select>
  
  <h1>Media library</h1>
  refId: <input id="skylineRefId" type="text"/> <br/>
  referableId: <input id="skylineReferableId" type="text"/> <br/>
  referableType: <input id="skylineReferableType" type="text"/> <br/>
  referableLocation: <input id="skylineReferableLocation" type="text">
  
  <h1>External</h1>
  URL: <input id="externalLocation" type="text"/>
  
  <h1>Image</h1>
  
  Alt: <input id="imageAlt" type="text" />
  Align: <select id="imageAlign"><option>Left</option><option>Center</option><option>Right</option></select>
  
  <div class="submit">
    <input type="button" onclick="Skyline.Dialog.current.insertAndClose();" value="OK"/>
  </div>
</div>

<script type="text/javascript" charset="utf-8">
  Skyline.Dialog.current.setTitle("Select image");
</script>